Serum galactomannan value as a prognostic value in chronic pulmonary aspergillosis
Satoru Fujiuchia Kazushi Doushitab Masaaki Takahashib Yasushi Yamamotob Akinori Takedab Yutaka Nishigakia Yuka Fujitab Yasuhiro Yamazakib Toshiaki Fujikaneb
aDepartment of Clinical Research, National Hospital Organization Asahikawa Medical Center
bDepartment of Respiratory Medicine, National Hospital Organization Asahikawa Medical Center
To elucidate prognostic factors for chronic pulmonary aspergillosis (CPA), we conducted a single institute’s retrospective study. We reviewed medical records of CPA patients managed in our hospital from January 2001 to December 2008. A patient was enrolled after meeting all of the following criteria: 1) clinical manifestations, such as cough, bloody sputum, hemoptysis, pyrexia, or dyspnea; 2) radiological findings, such as a new infiltrative shadow, cavitary expansion, hyperplasia of the cavity wall, progressive pleural thickening, or niveau formation; 3) antimicrobial refractory inflammation; and 4) presence of aspergillus precipitin. We defined date of diagnosis at the day of the positive aspergillus precipitin test. Survival period was evaluated since the day of diagnosis. The serum galactomannan and the β-D glucan value at the time of diagnosis were applied for analytical data. Age, gender, BMI, and underlying pulmonary diseases did not affect prognosis. Isolation of fungi and serum β-D glucan value at diagnosis did not affect mortality. However, a higher serum galactomannan level (more than 0.5 cutoff index) at diagnosis results in significantly increasing mortality. This study suggested that CPA patients who present higher serum galactomannan should be considered for early intervention.
Chronic pulmonary aspergillosis Prognositic factors Garactomannan
Received 7 Oct 2011 / Accepted 2 Feb 2012
AJRS, 1(4): 283-286, 2012